Objective:To analyze the body composition of patients diagnosed with malignant gastrointestinal tumors and to assess the impact of obesity on surgical outcomes and postoperative recovery following laparoscopic radical surgery.Methods:Patients with malignant gastrointestinal tumors who underwent laparoscopic surgery in the Department of General Surgery at the First Medical Center of the Chinese PLA General Hospital from February to October 2023 were prospectively enrolled. The body composition was measured by bioelectrical impedance analysis. Accordingly, the obese patients were selected as the obese group, while non-obese patients entered the control group using propensity score matching. The clinical data, in particular the postoperative recovery, were compared between these two groups.Results:A total of 593 patients with malignant gastrointestinal tumors were included in the analysis, including 108 patients in the obese group and 107 in the control group. The two groups significantly differed in the six minute walking test ( P=0.003), postoperative anemia ( P=0.036), white blood cell count ( P<0.001), neutrophil percent ( P<0.001), and neutrophil-to-lymphocyte ratio (NLR) ( P=0.001). The obese group exhibited a significntly higher risk of developing complications after surgery ( P=0.039). Conclusions:Obese patients with malignant gastrointestinal tumors are more likely to experience complications such as muscle weakness, anemia, infection, and inflammation after a laparoscopic radical surgery. Close monitoring and proactive perioperative interventions should be taken to mitigate such risks.

Objective:To analyze and identify the risk factors for preoperative hypokalemia in patients with gastrointestinal tumors and to construct a risk prediction model.Methods:A prospective research design was implemented. Patients with gastrointestinal tumors who underwent surgical treatment at the First Medical Center of the People ′s Liberation Army General Hospital between March 2023 and February 2024 were recruited as research participants through convenience sampling. These participants were randomly allocated into a modeling group or a validation group in a 7:3 ratio. Preoperative hypokalemia was defined as the outcome indicator. Multivariate Logistic regression analysis was employed to screen for risk factors, and a nomogram was subsequently constructed and validated. Results:Finally, a total of 600 patients were included in the study. In the modeling group ( n=420), 282 were male and 138 were female, 169 patients were under 60 years old, 233 patients were aged between 60 and 80 years, and 18 patients were over 80 years old. In the verification group ( n=180), there were 123 males and 57 females. Among these, 69 patients were under 60 years old, 102 patients were aged between 60 and 80 years, and 9 patients were over 80 years old. The multivariate Logistic regression analysis revealed that body mass index, occupation type, dietary habits, 6m walking speed test, grip strength relative to body mass index, and presence of digestive tract symptoms were independent risk factors for the development of preoperative hypokalemia ( χ2 values were 8.21~27.78, all P<0.05). The results of the model validation demonstrated that the areas under the receiver operating characteristic curves for the modeling and validation groups were 0.853 (95% CI 0.811-0.895) and 0.834 (95% CI 0.756-0.912), respectively, indicating a satisfactory level of predictive performance. Conclusions:The developed predictive model for preoperative hypokalemia in gastrointestinal tumors facilitates the accurate evaluation of the risk of preoperative hypokalemia and serves as a reference for effective clinical intervention.

Objective To systematically analyze the characteristics of impairment of speech function and activity limitation of com-munication in children with intellectual disabilities,and to develop comprehensive rehabilitation interventions.Methods An in-depth analysis of impairments of speech functions and activity limitation of communication in children with intellectual disabilities across multiple dimensions was conducted using International Classification of Func-tioning,Disability and Health(ICF)framework,from the aspects of body structures and functions,activities and participation,and environmental factors.Integrated intervention methods were implemented within speech reha-bilitation and special education settings.Results Speech function impairments often manifested as deficits in the mental functions of language,articulation func-tions,and the fluency and rhythm of speech.Communication limitations were evident,including potential defi-cits or difficulties in speaking,listening,engaging in conversations and interpersonal interactions.Environmental factors such as family support,peer attitudes,professional services and the accessibility of assistive communica-tion technologies significantly impacted the development of speech function and communication activity in these children.This study proposed a systematic assessment methodology for children's speech function and communi-cation activity based on the ICF framework,emphasizing a holistic understanding of impairments of speech func-tions and activity limitation of communication in children with intellectual disabilities,and highlighting the im-pact of communication activity on children's learning and daily life.In speech rehabilitation therapy and educa-tional rehabilitation settings,individualized intervention strategies should be designed according to the specific characteristics of impairments of speech functions and activity limitation of communication in children with intel-lectual disabilities,focusing on fostering functional communication skills and integrating them into daily life and educational activities.Augmentative and alternative communication technologies,natural context language inter-ventions,visual supports,and peer-mediated interventions might be effective.Conclusion This study has utilized the ICF framework to systematically analyze impairments of speech functions and ac-tivity limitation of communication in children with intellectual disabilities,interms of body functions and struc-tures,activities and participation,and environmental factors.A systematic approach to promoting the develop-ment of speech function and communication activity in children with intellectual disabilities has been proposed within speech rehabilitation therapy and educational rehabilitation settings,including individualized intervention strategies,the application of assistive technologies,the use of visual support,and the implementation of peer-me-diated interventions.

Objective:To analyze the body composition of patients diagnosed with malignant gastrointestinal tumors and to assess the impact of obesity on surgical outcomes and postoperative recovery following laparoscopic radical surgery.Methods:Patients with malignant gastrointestinal tumors who underwent laparoscopic surgery in the Department of General Surgery at the First Medical Center of the Chinese PLA General Hospital from February to October 2023 were prospectively enrolled. The body composition was measured by bioelectrical impedance analysis. Accordingly, the obese patients were selected as the obese group, while non-obese patients entered the control group using propensity score matching. The clinical data, in particular the postoperative recovery, were compared between these two groups.Results:A total of 593 patients with malignant gastrointestinal tumors were included in the analysis, including 108 patients in the obese group and 107 in the control group. The two groups significantly differed in the six minute walking test ( P=0.003), postoperative anemia ( P=0.036), white blood cell count ( P<0.001), neutrophil percent ( P<0.001), and neutrophil-to-lymphocyte ratio (NLR) ( P=0.001). The obese group exhibited a significntly higher risk of developing complications after surgery ( P=0.039). Conclusions:Obese patients with malignant gastrointestinal tumors are more likely to experience complications such as muscle weakness, anemia, infection, and inflammation after a laparoscopic radical surgery. Close monitoring and proactive perioperative interventions should be taken to mitigate such risks.

Objective Responding to the imperative to modernize vocational education and establish competency-oriented systems,this study investigates the development of on-campus training bases for speech and hearing rehabilitation(SHR)programs within Chinese higher vocational colleges(HVC).It analyzes their functional role and essential compo-nents,and propose a competency-oriented,modular framework for on-campus training based on World Health Organization(WHO)rehabilitation competency framework(RCF),and professional education standards.Methods This research synthesized theories of higher vocational education and practical pedagogy(e.g.,situated learn-ing,experiential learning and constructivism)with analyses of domestic and international SHR educational poli-cies and standards.It examined the strategic importance and essential components(hardware,software,human re-sources,management)of on-campus training bases in the context of higher vocational education.Synthesizing RCF with standards from ASHA(knowledge and skills acquisition,KASA),International Association of Logope-dics and Phoniatrics(IALP),and Teaching Standards for Higher Vocational Schools from Ministry of Education of the People's Republic of China,a core SHR professional competency model tailored for HVC was developed.This model subsequently guided the design of a modular on-campus training curriculum and associated pedagogi-cal approaches.Results On-campus training bases were pivotal platforms that bridge theory and practice,facilitating'teaching-learning-doing'integration within HVC SHR programs.Effective base construction necessitated synergistic integration across four key domains:hardware facilities(meeting specialized acoustic/equipment needs),software resources(case libraries,standard operating procedure and digital tools),'dual-role'human resources and robust manage-ment systems(operations,evaluation,industry-education linkages).Derived from RCF and related standards,a core SHR competency framework was developed,encompassing dimensions such as foundational knowledge and ethics,assessment(audiological;speech-language),intervention(audiological rehabilitation and technology;speech-language),and communication and collaboration.Consequently,eight core training modules were de-signed,including basic operations of hearing testing,introduction to objective hearing testing,preliminary hear-ing aid fitting,application of standardized speech-language assessment tools,simulation of articulation and voice disorder assessment and intervention,simulation of swallowing disorder screening and basic training,comprehen-sive case analysis and rehabilitation plan development,and practice of professional literacy and communication skills;detailing objectives,activities,and resources,and intended for seamless integration with theoretical cours-es and off-campus practicum,establishing a cohesive'curriculum-training-practicum'continuum.Furthermore,a suite of adaptable pedagogical models,including problem-based learning,case-based learning,simulation-based training,project-based learning and the flipped classroom,were recommended for implementing these modules.Conclusion The effective development of on-campus training bases for SHR programs in HVC necessitates establishing a systematic,competency-oriented practical teaching environment.Grounded in RCF,and essential SHR knowl-edge,skills and abilities,this study proposes a framework incorporating eight core training modules and comple-mentary pedagogical models,providing a theoretically grounded,practically applicable blueprint for enhancing the educational quality and substance of these bases within HVC.Successful realization hinges upon the synergis-tic development of the four key elements(hardware,software,human resources,management),deep integration between training activities,the curriculum,and practicum experiences,and the application of innovative pedago-gy to cultivate student potential.

Objective Responding to the imperative to modernize vocational education and establish competency-oriented systems,this study investigates the development of on-campus training bases for speech and hearing rehabilitation(SHR)programs within Chinese higher vocational colleges(HVC).It analyzes their functional role and essential compo-nents,and propose a competency-oriented,modular framework for on-campus training based on World Health Organization(WHO)rehabilitation competency framework(RCF),and professional education standards.Methods This research synthesized theories of higher vocational education and practical pedagogy(e.g.,situated learn-ing,experiential learning and constructivism)with analyses of domestic and international SHR educational poli-cies and standards.It examined the strategic importance and essential components(hardware,software,human re-sources,management)of on-campus training bases in the context of higher vocational education.Synthesizing RCF with standards from ASHA(knowledge and skills acquisition,KASA),International Association of Logope-dics and Phoniatrics(IALP),and Teaching Standards for Higher Vocational Schools from Ministry of Education of the People's Republic of China,a core SHR professional competency model tailored for HVC was developed.This model subsequently guided the design of a modular on-campus training curriculum and associated pedagogi-cal approaches.Results On-campus training bases were pivotal platforms that bridge theory and practice,facilitating'teaching-learning-doing'integration within HVC SHR programs.Effective base construction necessitated synergistic integration across four key domains:hardware facilities(meeting specialized acoustic/equipment needs),software resources(case libraries,standard operating procedure and digital tools),'dual-role'human resources and robust manage-ment systems(operations,evaluation,industry-education linkages).Derived from RCF and related standards,a core SHR competency framework was developed,encompassing dimensions such as foundational knowledge and ethics,assessment(audiological;speech-language),intervention(audiological rehabilitation and technology;speech-language),and communication and collaboration.Consequently,eight core training modules were de-signed,including basic operations of hearing testing,introduction to objective hearing testing,preliminary hear-ing aid fitting,application of standardized speech-language assessment tools,simulation of articulation and voice disorder assessment and intervention,simulation of swallowing disorder screening and basic training,comprehen-sive case analysis and rehabilitation plan development,and practice of professional literacy and communication skills;detailing objectives,activities,and resources,and intended for seamless integration with theoretical cours-es and off-campus practicum,establishing a cohesive'curriculum-training-practicum'continuum.Furthermore,a suite of adaptable pedagogical models,including problem-based learning,case-based learning,simulation-based training,project-based learning and the flipped classroom,were recommended for implementing these modules.Conclusion The effective development of on-campus training bases for SHR programs in HVC necessitates establishing a systematic,competency-oriented practical teaching environment.Grounded in RCF,and essential SHR knowl-edge,skills and abilities,this study proposes a framework incorporating eight core training modules and comple-mentary pedagogical models,providing a theoretically grounded,practically applicable blueprint for enhancing the educational quality and substance of these bases within HVC.Successful realization hinges upon the synergis-tic development of the four key elements(hardware,software,human resources,management),deep integration between training activities,the curriculum,and practicum experiences,and the application of innovative pedago-gy to cultivate student potential.

Objective:To analyze and identify the risk factors for preoperative hypokalemia in patients with gastrointestinal tumors and to construct a risk prediction model.Methods:A prospective research design was implemented. Patients with gastrointestinal tumors who underwent surgical treatment at the First Medical Center of the People ′s Liberation Army General Hospital between March 2023 and February 2024 were recruited as research participants through convenience sampling. These participants were randomly allocated into a modeling group or a validation group in a 7:3 ratio. Preoperative hypokalemia was defined as the outcome indicator. Multivariate Logistic regression analysis was employed to screen for risk factors, and a nomogram was subsequently constructed and validated. Results:Finally, a total of 600 patients were included in the study. In the modeling group ( n=420), 282 were male and 138 were female, 169 patients were under 60 years old, 233 patients were aged between 60 and 80 years, and 18 patients were over 80 years old. In the verification group ( n=180), there were 123 males and 57 females. Among these, 69 patients were under 60 years old, 102 patients were aged between 60 and 80 years, and 9 patients were over 80 years old. The multivariate Logistic regression analysis revealed that body mass index, occupation type, dietary habits, 6m walking speed test, grip strength relative to body mass index, and presence of digestive tract symptoms were independent risk factors for the development of preoperative hypokalemia ( χ2 values were 8.21~27.78, all P<0.05). The results of the model validation demonstrated that the areas under the receiver operating characteristic curves for the modeling and validation groups were 0.853 (95% CI 0.811-0.895) and 0.834 (95% CI 0.756-0.912), respectively, indicating a satisfactory level of predictive performance. Conclusions:The developed predictive model for preoperative hypokalemia in gastrointestinal tumors facilitates the accurate evaluation of the risk of preoperative hypokalemia and serves as a reference for effective clinical intervention.

Objective To systematically analyze the characteristics of impairment of speech function and activity limitation of com-munication in children with intellectual disabilities,and to develop comprehensive rehabilitation interventions.Methods An in-depth analysis of impairments of speech functions and activity limitation of communication in children with intellectual disabilities across multiple dimensions was conducted using International Classification of Func-tioning,Disability and Health(ICF)framework,from the aspects of body structures and functions,activities and participation,and environmental factors.Integrated intervention methods were implemented within speech reha-bilitation and special education settings.Results Speech function impairments often manifested as deficits in the mental functions of language,articulation func-tions,and the fluency and rhythm of speech.Communication limitations were evident,including potential defi-cits or difficulties in speaking,listening,engaging in conversations and interpersonal interactions.Environmental factors such as family support,peer attitudes,professional services and the accessibility of assistive communica-tion technologies significantly impacted the development of speech function and communication activity in these children.This study proposed a systematic assessment methodology for children's speech function and communi-cation activity based on the ICF framework,emphasizing a holistic understanding of impairments of speech func-tions and activity limitation of communication in children with intellectual disabilities,and highlighting the im-pact of communication activity on children's learning and daily life.In speech rehabilitation therapy and educa-tional rehabilitation settings,individualized intervention strategies should be designed according to the specific characteristics of impairments of speech functions and activity limitation of communication in children with intel-lectual disabilities,focusing on fostering functional communication skills and integrating them into daily life and educational activities.Augmentative and alternative communication technologies,natural context language inter-ventions,visual supports,and peer-mediated interventions might be effective.Conclusion This study has utilized the ICF framework to systematically analyze impairments of speech functions and ac-tivity limitation of communication in children with intellectual disabilities,interms of body functions and struc-tures,activities and participation,and environmental factors.A systematic approach to promoting the develop-ment of speech function and communication activity in children with intellectual disabilities has been proposed within speech rehabilitation therapy and educational rehabilitation settings,including individualized intervention strategies,the application of assistive technologies,the use of visual support,and the implementation of peer-me-diated interventions.

Objective To observe the effects of acupuncture at acupoints along the meridians on the expression of frontal lobe associated protein kinase in pchlorophenylalanine(PCPA)induced insomnia rats;To explore the mechanism of acupuncture in improving insomnia.Methods Totally 60 rats were randomly divided into blank group,model group,sham acupuncture group,acupuncture group and Western medicine group,with 12 rats in each group.An insomnia model rat was induced by intraperitoneal injection of PCPA.The acupuncture group received acupuncture at"Baihui","Shenmen"(bilateral),and"Sanyinjiao"(bilateral),while the sham acupuncture group only fixed the needle at the corresponding acupoints but did not penetrate the skin,while the model group was only fixed for 30 minutes,the Western medicine group was given a solution of estazolam by gavage for 7 consecutive days,the blank group was not treated.The pentobarbital sodium reversal experiment was used to detect the sleep latency and sleep time of rats,ELISA was used to detect the content of melatonin(MT)in plasma,RT-PCR was used to detect the mRNA expressions of calmodulin dependent protein kinase(CaMK)Ⅱ,protein kinase C(PKC)and p38 mitogen activated protein kinase(MAPK)in frontal lobe tissue,and Western blot was used to detect the protein expressions of CaMKⅡ,PKC and p38MAPK in frontal lobe tissue.Results Compared with the blank group,the sleep latency of the model group rats were significantly prolonged and the sleep time were significantly shortened(P<0.01),the content of MT in plasma was significantly reduced(P<0.01),and the mRNA and protein expressions of CaMKⅡ and PKC in frontal lobe tissue were significantly decreased(P<0.01),the mRNA and protein expressions of p38MAPK were significantly increased(P<0.01).Compared with the model group,the sleep latency were significantly shortened and the sleep time were significantly prolonged in the acupuncture group and the Western medicine group(P<0.01),the plasma MT content significantly increased(P<0.01),the mRNA and protein expressions of CaMKⅡ and PKC in frontal lobe tissue significantly increased(P<0.05),and the mRNA and protein expression of p38MAPK significantly decreased(P<0.01).Compared with the sham acupuncture group,the sleep latency shortened and sleep time were significantly prolonged in the acupuncture group and the Western medicine group(P<0.01),plasma MT content significantly increased(P<0.01),PKC mRNA expression in frontal lobe tissue significantly increased(P<0.01),and p38MAPK mRNA expression significantly decreased(P<0.01).There was no statistically difference in various indicators between the acupuncture group and the Western medicine group(P>0.05).Conclusion Acupuncture at acupoints along the meridians can shorten the sleep latency and prolong sleep time,improve sleep status by regulating the expression of associated protein kinase in frontal lobe of insomnia rats.

Objective Based on the bio-psycho-social model of functioning and health of International Classification of Function-ing,Disability and Health(ICF)framework,this paper systematically analyzes rehabilitation-related policy docu-ments of the World Health Organization(WHO)to explore the theoretical and policy principles,service systems,priority development areas,and main policy and technical measures for speech and language rehabilitation for children with hearing impairment. Methods Under literature research and policy analysis methods,this paper systematically reviewed the functioning and health framework of ICF,relevant WHO policy reports and American Speech and Hearing Association technical documents,analyzed the current status and needs of rehabilitation services in China,and proposed a theoretical framework,priority areas,and main policy and technical measures for constructing an ICF-based speech and lan-guage rehabilitation service system for children with hearing impairment. Results There were eight major principles for the development of speech and language rehabilitation for children with hearing impairment:child-centered and respect for individual differences,life-cycle support and promoting con-tinuous development,evidence-based practice,multidisciplinary collaboration,building family participation sup-port networks,promoting integrated education and social participation,focusing on cultural sensitivity,and tech-nology-empowered rehabilitation innovation.Five service systems were elaborated,including comprehensive ear-ly screening,diagnosis,and intervention system;family and social support system;multidisciplinary team servic-es system;comprehensive,multi-level speech and language rehabilitation service system;and digitally empow-ered services to build new rehabilitation service models.The priority development areas,and main policy and technical measures for speech and language rehabilitation for children with hearing impairment were also dis-cussed. Conclusion Based on the bio-psycho-social model of functioning and health of ICF,comprehensive,personalized,con-tinuous,high-quality and universally accessible speech and language rehabilitation services can be developed by implementing measures,such as strengthening policy support,improving service systems,cultivating multidisci-plinary professionals,promoting digital empowerment technologies and enhancing support system,to promote the overall development,social participation and quality of life for children with hearing impairment.